For the past 15 years Dr. Saag has devoted the majority of his career efforts to patient-oriented research in pharmacoepidemiology (drug safety and comparative effectiveness) research and evidence implementation (a branch of outcomes or Type 2 translational) research of the rheumatic diseases. In addition to competing successfully for peer reviewed funding, including the third renewal of his AHRQ supported Center for Education and Research on Therapeutics (CERTs) of musculoskeletal disorders, Dr. Saag has published or has in press 119 original scientific reports (75 with mentees as authors). Since the award of his K24 in 2005, Dr. Saag has served as a primary or secondary mentor for 22 pre and post- doctoral trainees. Along with his work as director of the CERTs, Dr. Saag's mentoring is facilitated by his role as director of the UAB Center for Outcomes, Effectiveness Research and Education and its T32 Health Services Research Training Grant. Renewal of his K24 grant would preserve Dr. Saag's protected time at 50% or greater effort and relieve future clinical and administrative responsibilities. Research proposed includes 3 current projects, 3 new projects and 4 future projects addressing novel questions about biologics agent safety in adults and children with inflammatory arthritis;evidence implementation research in osteoporosis;pharmacoepidemiology of osteoporosis examining adherence, comparative effectiveness, and bisphosphonate safety;and gout epidemiology. All the research proposed provide mentoring opportunities and make use of currently available large datasets, including national Medicare/Medicaid data. Dr. Saag will continue to recruit two or three new trainees into his research program each year, expand and refine his formal mentoring program using feedback received from trainees, and extend his leadership role in mentoring through the UAB Clinical &Translational Science Award (CTSA). UAB, its Schools, Departments, Divisions, and Interdisciplinary Research Centers provide an outstanding environment for the development of junior investigators in patient-oriented research. Based on institutional commitment and resources and Dr. Saag's successful record in research and mentoring, the renewal of Dr. Saag's K24 will maintain and greatly augment his ability to expand his research program aimed at developing the next generation of patient-oriented clinical investigators.